7th ICHNO Abstract book

7th ICHNO 7 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 14 – 16 March 2019 Barcelona, Spain __________________________________________________________________________________________ page 37

Hyponatremia at the point of recurrence of disease, in patients with recurrent or metastatic HNSCC, correlates with worse OS, which can be used as a prognostic marker on this population. The retrospective and single center design is a limitation, as well as the absence of data considering other etiologies for hyponatremia. Adequately designed prospective studies are necessary to validate these results. PO-071 Critical weight loss and feeding tube use in patients with HPV-positive oropharynx cancer B. Vangelov 1 , D. Kotevski 1 , J. Williams 1 , R. Smee 1 1 Prince of Wales Hospital, Radiation Oncology, Sydney, Australia PO-072 Differentiated dysplasia, an undervalued precursor of oral squamous cell carcinoma S.Koljenovic 1 , S. Dasgupta 1 , P. Ewing-Graham 1 , V. De Water 2 , I. Ten Hove 2 , R. Baatenburg de Jong 3 , E. Wolvius 2 , F. Van Kemenade 1 , G. Puppels 4 , V. Noordhoek Hegt 1 1 Erasmus MC, Pathology, Rotterdam, The Netherlands; 2 Erasmus MC, Oral and Maxillofacial Surgery, Rotterdam, The Netherlands; 3 Erasmus MC, Otorhinolaryngology, Rotterdam, The Netherlands; 4 Erasmus MC, Center for Optical Diagnostics, Rotterdam, The Netherlands Purpose or Objective According to the current WHO classification, oral squamous cell carcinoma (OSCC) is postulated to arise from dysplastic precursor stages, from low to high grade. The more advanced degree of dysplasia, the higher the likelihood of developing OSCC. From literature it appears, however, that OSCC may also be preceded by lesions that are seemingly non-dysplastic or low grade on histology. The histology of these lesions is subtle and shows great conformity with the well-known entity differentiated dysplasia of vulva and penis, which is known to have a rapid progression to invasive carcinoma. Accordingly, similar alterations in oral cavity have been named ‘differentiated oral dysplasia’. This entity was first identified by Japanese pathologists in 2007, but reports on this type of dysplasia in English language literature are scarce. In our study, we determined reliable histological criteria for diagnosis of differentiated oral dysplasia and assessed the usefulness of immunohistochemical markers for supporting the diagnosis. We also estimated the frequency of differentiated dysplasia in OSCC cases from our institute. Material and Methods All OSCC cases from 2014-2017 were studied for presence of dysplasia. Specific histological features of differentiated dysplasia were recorded, and inter- observer agreement for the diagnosis was measured. Staining pattern for immunohistochemical markers CK13 and CK17-MIB1 was recorded. Results Of the 207 OSCC cases, differentiated dysplasia was present in 69%, usual dysplasia in 17%, and dysplasia with features of both types in 8%. Six percent were indefinite for dysplasia. In 27% of differentiated dysplasia, histological changes were conspicuous and easily discernable. However, in the remaining 73% the changes were subtle, and detectable only on higher magnification. Despite this, inter-observer agreement was ‘substantial’ (Kappa = 0.66) for the diagnosis of differentiated dysplasia based on criteria defined in this study. Abstract withdrawn

The objective response rate with PF was 52.63%, and was statistically significant when compared with TP (P= 0.030). The disease control rate with PF was 63.15% and was statistically significant when compared with TP. (P= 0.005). The toxicities between two drug regimens were predominantly grade I and not statistically significant. The surgical conversion with PF was 68.4% and with PF was 25%, which was statistically significant. (P= 0.010). Conclusion Locally advanced oral cancers require multimodality management for optimal oncological outcomes. This study showed that NACT is a feasible option in locally advanced oral cancers. The pilot study demonstrated clinically meaningful difference between the two arms, showing that the objective response rate, disease control rate and surgical conversion was significantly better with PF compared to TP. PO-070 Prognostic value of hyponatremia on metastatic or recurrent head and neck squamous cell carcinoma C. Melo Alvim Moreira 1 , P. Semedo 1 , R. Paiva 1 , S. Lobo Martins 1 , H. Pais 1 , A.L. Costa 1 , L. Ribeiro 1 , L. Costa 1 1 Centro Hospitalar Lisboa Norte, Medical Oncology Department, Lisbon, Portugal Purpose or Objective Hyponatremia is one of the most common electrolytes disturbances in oncological patients. It’s incidence in cancer patients has been reported in as many as 47 % of hospital admissions, and the frequency of moderate to severe hyponatremia in hospitalized patients can range from 24 to 50 %, depending on malignancy type. In lung cancer and lymphoproliferative diseases hyponatremia has been associated with bad prognosis. However, its role in patients with head and neck squamous cell carcinoma (HNSCC) is still not well defined. The aim of this study was to evaluate the role of hyponatremia as a prognostic factor in patients with metastatic or recurrent HNSCC. Material and Methods This was an observational and retrospective cohort study. Clinical and pathologic data were collected from clinical files of patients with HNSCC between 01-01-2008 and 31- 12-2017 followed at the Oncology Department in Centro Hospitalar Lisboa Norte - Hospital de Santa Maria. The primary endpoint was to evaluate the correlation between natremia value (≥135 mmol/L or <135 mmol/L) at time of metastasis or recurrence and overall survival (OS). Statistical analysis was performed using Kaplan-Meier method and Cox regression analysis. Results From our sample, 37 patients (45.2%) had hyponatremia (Na+ <135 mmol/L) and 45 (54,9%) had Na+ ≥135 mmol/L. No significant differences were identified between the two groups concerning the median age at diagnosis (56 years old (IQR 51-70) vs 56 years old (IQR 32-61)), male gender (n=30, 81,1% vs n=39, 86,7%), ECOG < 2 (n=34, 91.9% vs n=41, 91.1%), tobacco (n=31, 83,8% vs n=36, 80%) and alcohol consumption (n=16, 43,2% vs n= 21, 46,7%), stage at diagnosis ( predominantly stage IVA n=16; 43.2% vs n=24, 53,3%) or primary tumor location (mostly on oral cavity n=20; 54.1% vs n=24, 53,3%). With a median follow- up of 17.3 months (IQR 36.3-88.5), OS was 3.94 months (CI 95% 2.8-5.0) on the Na+ <135 mmol/L group and 7.75 months (CI 95% 6.67-8.83) on the Na+≥135 mmol/L group. This difference was significant when using univariate and multivariate analysis (HR 2.18; CI 1.4-3.5; p=0.001) and (HR 2.11; CI 1.2 – 3.4; p= 0.003) respectively.

Conclusion